A major problem regarding the spread of illness is the contamination of food by food service workers who carry pathogens on their hands and transmit them to food. Lack of proper hand washing in the food processing industry is also of concern where raw meats, fish, and vegetables can be contaminated by handling these items with hands that are contaminated with pathogens. Furthermore, health care workers may contaminate patients with unsanitary hands.
Hands become contaminated by touching body parts or objects contaminated with pathogens. Individuals may carry pathogens in their gastrointestinal tract, skin, nasal passage, etc. Hands may also become contaminated by handling trash, soiled dishes, or other items, such as door knobs that have been touched by a carrier of a pathogen.
Illness caused by hands contaminated with pathogens is well recognized and documented in the food service industry. It is estimated that 30% of all food-borne illness is caused by pathogens being transferred from contaminated hands to food and subsequently being ingested by the host. Contaminated hands are the major source for spreading food-borne illness caused by viral infections (e.g. Hepatitis A, Norovirus Gastroenteritis, and Rotavirus Gastroenteritis), some bacterial infections (e.g. Shigellosis, Staphylococcal Gastroenteritis, and Hemorrhagic Colitis), as well as some parasitic infections (e.g. Giardia Duodenalis, Toxoplasmosis, Intestinal Cryptosporidiosis, and Cyclosporiasis).
Public health officials are acutely aware that contaminated hands are also a major source of infections. Nosocomial infections are a major source of morbidity and mortality. These infections are often carried by health care workers. It has been estimated that a high percentage of hospital workers are Staphylococcal aureus carriers. Several strains of Staphylococcal aureus have become resistant to most antibiotics resulting in increased hospital mortality rates. Viral disease outbreaks in health care facilities, including hospitals, nursing homes, assisted living facilities, physicians and dentist offices, etc. have been reported. Interestingly, one study found that only a small percentage of health care workers follow proper hand washing or sanitizing practices. Some upper respiratory infections are spread from person to person by hand contact with pathogen-contaminated objects followed by contaminated hand-to-nose, hand-to-eye or hand-to-ear contact. Hand transmission has been shown to be the main route for spreading the common cold and would be a major route for transmission of an avian flu epidemic.
The FDA has written guidelines for hand washing in food service establishments. These guidelines are put into practice by states and local governments overseeing the regulation of food safety. The Educational Foundation of the National Restaurant Association has established within its ServSafe Certification Program an effective hand washing method (referred to hereinafter as the “ServSafe Guidelines”). The ServSafe Guidelines for proper hand washing are as follows: wet both hands with warm water, (near 100 deg. F.), apply soap, vigorously scrub the hands and arms for at least twenty seconds, clean under the fingernails and between the fingers, rinse the hands and arms thoroughly under running water, and then dry the hands and arms with a single-use paper towel or warm air hand dryer.
Several recent studies have indicated the superiority of alcohol-based hand sanitizers over soap products in reducing the microbial count on hands. Reducing the microbial count thereby reduces the potential for transmission of infection. These observations, plus the fact that the alcohol-based sanitizers are considered less irritating to skin, have led some opinion leaders to recommend increased usage of alcohol based sanitizers in the health care setting.
The mere establishment of proper hand washing and sanitizing procedures, however, does not guarantee compliance by food service workers. There are daily newspaper reports of health inspections where critical hand washing violations by food service workers take place on a routine basis. Often, when a food service or health care worker is suspected to be in violation of proper hand washing, the worker may just simply claim that they did wash their hands.
In an effort to monitor proper hand washing, devices that count hand washings have been patented and marketed to food service establishments. The device essentially requires the identification of the food service worker who is washing their hands. That is, the food service worker enters their personal Pin # into a computer device when they wash their hands. Such devices have not been widely accepted by the Industry. The major problems with these devices are: a) the inability to verify that proper hand washing has taken place; b) the lack of compliance with entering the Pin #; c) the lack of room for the device in the usually cramped quarters next to the hand washing sink; d) the relatively high cost purchasing and maintaining the device; and e) the inability to verify or monitor the use of alcohol-based sanitizers. Given the absence of a widely accepted method, it is difficult for food sanitation inspectors to monitor and verify proper hand washing and sanitizing practices.
A food sanitation inspector is in a food service establishment for a short time (usually 0.5-2 hours). Because the inspector is busy with other aspects of the inspection, the inspector is likely to miss improper hand washing by some, if not most, of the workers. Managers and inspectors of health care workers are in the same position as those in the food service industry. Food service managers are burdened with other responsibilities including supervising food logistics, food delivery, food storage, food preparation, food cooking, food holding, customer service, food establishment maintenance and record keeping, which leave little time for monitoring proper hand washing practices.
Furthermore, the skin on the hands of workers who routinely carry out proper hand washing practices will eventually become accommodated to hand washing. The workers with accommodated hands will respond differently to proper hand washing as compared to those subjects who do not practice proper hand washing or seldom wash their hands.
Therefore, a need exists for a composition and method for verifying and monitoring hand washing and sanitizing practices in the food and health care industries. The composition will preferably be a hand sanitizer that raises and maintains elevated skin surface pH for at least thirty minutes. The method comprises the use of skin surface pH on designated sites of the hands to verify whether the individual's hands have been properly washed and sanitized.